THE DOMUS PHILOSOPHY - A PROSPECTIVE EVALUATION OF 2 RESIDENTIAL UNITS FOR THE ELDERLY MENTALLY-ILL

This article reports the findings of a prospective study of the first year of operation of two residential domus units for elderly people wi th dementia (domus A) and chronic schizophrenia (domus B). Residents, staff and the process of care were assessed at baseline in long-stay m ental hospital wards, and at 3 months, 6 months and 12 months after th e move to a domus. At 12 months, both domuses were providing more poli cy choice, resident control, provision for privacy and availability of social and recreational activities than a baseline psychogeriatric wa rd. Residents' cognitive function improved steadily over the follow-up period in both domuses, significantly so in domus A. There was also s ome improvement in residents' self-care (ADL) skills at follow-up in b oth domuses. Residents' communication skills were rated as significant ly improved by staff in domus A at all follow-up assessments, and by s taff in domus B at 6 months. Compared to baseline, substantially highe r levels of activities and interpersonal interactions were observed at follow-up in both domuses. There was no evidence that staff suffered from low job satisfaction or psychological impairment at either domus.